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General NPI Number Information
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NPI Number | 1437706934
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Entity Type | Organization
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Legal Business Name | SIRINTR/SUK PLLC
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 6085 S FORT APACHE RD STE 120-130
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City | LAS VEGAS
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State | NV
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Zip | 89148-5545
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Country | US
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Telephone | 858-204-7724
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Fax |
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Provider Business Mailing Address
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Address Line | 10999 GAELIC HILLS DR
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City | LAS VEGAS
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State | NV
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Zip | 89141-4393
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DONG SUK
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Credential | OD
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Telephone | 858-204-7724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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